2025 Highlights: 30 Guests on One Thing You Can Do This Week

Ep. 133: 2025 Highlights – 30 Guests on One Thing You Can Do This Week

Here’s what to expect on this week’s episode. 🎙️

If you only did one thing this week to improve your ASC, what should it be?

For our 2025 year-in-review episode of This Week in Surgery Centers, we’ve created a highlight reel from 30 guests and revisited their answers to our favorite closing question: What is one thing ASC leaders can do this week to improve their surgery centers? 

• In this rapid-fire episode, you’ll hear practical ideas on how to: 
• Empower your team (and show real appreciation on your busiest days) 
• Clean up payer profiles, item masters, and days to bill to unlock better margins 
• Tighten credentialing, monitoring, disaster plans, and IT policies before survey season 
• Improve caregiver and patient communication with a few simple conversations 
• Get your financials, cap table, and partnerships ready for the next phase of growth 

It’s 30 quick wins from a full year of conversations with ASC leaders, clinicians, and industry experts — packed into just half an hour.  

Be sure to check out the full episode on YouTube or your favorite podcast platform! 

Episode Transcript

[00:00:24] Alex Larralde: Hi everyone, and welcome back to This Week in Surgery Centers. I’m really excited about today’s episode because it’s a special one. It deviates from our typical format and instead of a guest conversation today, you’re going to hear from 30 guests that we’ve had on the podcast throughout the course of 2025. I pulled together a highlight reel of some of the best responses to that final question we ask our guests, and that question is, what is one thing ASC leaders can do this week to improve their surgery centers?

As you know, it’s been a big transition year, I took over the podcast along with Grant Duncan, and so you are going to see four different hosts throughout these clips, which is pretty cool. So, buckle up. It’s going to be a fun one.

I also want to let you know that this is not our final episode for the year. We are getting very close to the end of the calendar year. It’s just a few weeks away, and we’ll be talking to Kara Newbury from ASCA about the CMS final rule that we’ve all been waiting for, that came out on the 21^st [of November], and then we’ll have one final episode after that. So be sure to check back for updates, but this is our highlight reel. Without further ado, enjoy.

[00:01:25] Erica Palmer: All right, Becky, last question. What is one thing our listeners can do this week to improve their surgery centers?

[00:01:34] Becky Ziegler-Otis: What I would say is, one thing you can do is try to carve out time this week, and the reason I say carve out is because I know as an administrator, your week is already prepared. So I’m saying if you can try to just carve out maybe an hour of time, might be a lot of time to commit to this, to just do some rounds, go around, talk with your staff, talk with your surgeons, talk with your patients, and with the question saying, well, is there anything you think we can improve upon?

Because I think if you did that you would also have a plethora of information that could help you as you’re looking forward to what you need to do for your QAPI studies for the next year.

[00:02:15] Tina DiMarino: I think empowering team participation. I think that as administrators and with as busy as everything seems to be these days with staffing and surgeries picking up and things like that, really considering empowering your team and delegating out things evenly along the way, it does twofold.

It helps your administrator not be so overburdened as to doing all of it. On his or her own, but it also empowers the team to buy in more. So really targeting the team to help with different things that interest them infection control, or quality or risk or safety. So, I really think empowering the team to participate will really help your ASC in its improvements, and then also help just in an overall teamwork aspect of everything.

[00:03:06] Ryan Short: I think to really challenge the status quo of what you’ve seen in surgery centers.

There’s not a one size fits all approach, and I think if you’re designing a surgery center, it can be a once in a lifetime chance to really put your mark on your practice and do things the way that you want. Of course, within the stipulations of the building code and all those different things, but there’s so much innovation and creativity that goes on in ASCs these days. Challenge yourself, challenge your design team and hopefully you have a design team that that is up to that challenge and really work hard and develop that new model of practice that you’re excited about and make your dream a reality.

[00:03:42] Kathy Wilson: Take credit for the improvements that you make because you make them every day you do something, you tweak a process, you make something better for a patient. Take credit for it, whether it’s a study or not, but celebrate and communicate that to staff.

It makes them feel good about the work they’re doing and about the surgery center.

[00:04:05] Nick Latz: What’s one thing our listeners can do this week to improve their surgery centers?

[00:04:10] Scott Allen: I think you could go, I think this week you could probably go in and print out your current insurance payer profile list.

So, this is every insurance that you have loaded into your software system, right? Print that out. And go through it and organize it to make sure that you have a good naming convention. Meaning you want to make sure that you know that the front desk is always naming the payer the same way you’re, you know, productizing the payer.

Meaning that you’re distinguishing between H-M-O P-P-O Medicare Advantage. because I see a lot of issue with that. You know, we have a situation where, you know, I pulled one last week and we may, I may have had, you know, 200 different insurance profiles in, in this system. Half of them weren’t active, half of them were double.

And you know, the other thing is, if you’re not properly understanding the frequency of insurance product type, what if you’re sending an offer from a payer and they’re offering you different rates for HMO or PPO, how are you understanding that frequency difference? Right. So, I think what I would do is print out that insurance list of all of your active insurances and go through and organize it, clean it up.

And that’s also a recommended annual practice as well. Because I think that front desk is really so important to not only operation of the A-S-C-R-C-M but considering managed care contracting. You know, our data is only as good as what’s in the system. So, you know that management at that front end is key to make sure that, that I can look at your data on the back end properly and understand different things. So, hope that was helpful.

[00:05:43] Colin Park: I’ll say this, I’ll speak more to kind of those centers that are independent, that may be looking at a strategic partner or potentially selling some ownership. I would say first, decide what you want out of a partnership. Do you want help? Is, is your center currently being managed by physicians? And those physicians just want to be physicians, and they don’t want to manage the business anymore?

So do you want to shoot a strategic partner to help with. Managing the day-to-day operations. Do you want help with managed care contracting? Do you want help with staffing or billing and collections? So, I would say first and foremost. Decide what you want to get out of a partnership before you start going down the path of getting a partner.

Then I would, secondly, I would say most important, you know, get your house in order. So, get your financials cleaned up. Get a really good grasp on the economics of the center. Look at your cap table. Does your cap table need to be cleaned up? Do you have a bunch of positions that have ownership, that have retired or have relocated or.

Maybe violating one third from a violation perspective. Clean up your cap table. Basically, get all your financials together and, and really be able to tell your story or the story of your center to potential suitors.

[00:06:54] Melanie Howitt: Ultimately, a concentrated effort on maintaining a low claim submission timeframe your days to bill and analyzing those claim adjudication bottlenecks within claim rejections and payer adjudication lags.

It’ll give you a solid starting point to identify potential areas for improvement. Or if everything is going great, celebrate success of your staff.

[00:07:16] Nick Latz: Fantastic. I like the celebration piece. And if we double click on days to bill, do you have one or two tips for centers on how to bill faster?

[00:07:25] Melanie Howitt: On how to bill faster? Your documentation being in line as quickly as possible. Ultimately, you want to be looking at your mid days to be at two to three from the date of service documentation’s done. Coding’s done charge entries done by day three.

[00:07:41] Kristle Young: I think an actionable step that an ASC could take as a project is go in and audit their top 10 unpaid claims over the last 90 days.

Try to identify some common trends. Across those top 10, and I bet you’re going to find a very core foundational issue, whether it be authorizations that were missed, or is it a certain payer that’s just constantly asking for medical records, or is it a certain payer that’s not paying on time, or just is it coding errors?

Just really drill down and see why they’re not paid. Because I guarantee you’ll find a core foundational issue that can be addressed on the front end that can fix that problem.

[00:08:27] Erica Palmer: What is one thing our listeners can do this week to improve their surgery centers?

[00:08:33] Mayte Rechani: That’s a tough one. I have two answers. I don’t know. I’m trying to decide. Okay. I’ll take both. One. Okay. I will say. While we’re not a mind reader. If you recognize that you’re going to have an exceptional amount of surgeries in the coming weeks, try to be prepared because you cannot guarantee that there will not be an emergency, right? So, it’s better for me to be overly prepared at the same time that I don’t over promise. Changes can be made beforehand versus being not prepared and then all of a sudden everything is a fire, right? Understanding at the end of the day, the right agency partner is here to help you.

We’re not here to say, oh, you need to have someone for 13 weeks. Now, the right partner will say, listen, you only have a high census for four weeks. You don’t need to hire someone for four weeks and incur that cost. Let the agency take care of it. It’s four weeks. That person is guaranteed to be there.

That’s why they’re signing that contract. So, I guess, you know, be prepared and really rely on your agency. Really rely, not even agency because it’s such an ugly word. Rely on your partner. Because that’s what they’re there for. They’re there to work for you and with you.

[00:09:52] Mark Henderson Leary: Thought about this one a lot. This is the hardest leadership skill that people will develop and learn to tell the truth.

This is, this is one of the hardest things you’ll do when you see somebody who you’ve checked out on or you think is checked out on, but to really hold yourself accountable as a leader, to be in integrity with that person is below the bar and I’m no longer telling them, I’m no longer giving them feedback.

I am walking a wide berth around them and essentially endorsing their bad behavior. Everybody in the organization de deserves to know where they stand and give them that feedback to help them be better and give them the dignity and empower them to respond to that. It’s not your job to help them get there necessarily, you can help them, but it’s, you don’t need to force them to do the right thing.

You can treat them as adults. Give them the feedback, positive and negative, but make sure you’re telling the truth, whatever that truth is, whether they’re doing well, they’re not doing well, they could be better. And make sure you’re in integrity and don’t endorse non-confrontation. Don’t endorse or encourage that bad behavior.

[00:11:13] Maddie Traylor: So, I’m going to come at this more from a business standpoint because that’s the side that I’m on in that I think a lot of people I hear are afraid to spend money to make money, whether it be hiring the right provider for more money.

You really need to think about it like this, that you need to outsource things that you cannot do yourself or that cost you too much of your time. And if you are an ASC, whether you’re a de novo ASC, or you’ve been around forever. You can’t get too stuck in your own ways that you’re afraid to spend money on things that will ultimately lead to ROI.

But it might take time, and that really boils down to recruiting. In a whole sense and big picture is that you’re never going to make back what you pay somebody. Maybe even in the first couple of years when you’re thinking about, you know, surgeons, but eventually you will, and you have to have that long-term mindset rather than just the upfront cost of things.

[00:12:09] Richard Parker: Well, I think being intentional, that’s another area I see ASCs struggle with is disaster preparedness. And so, it is all connected, because a fire in an ASC would be a disaster, but polishing off those disaster plans or your fire response plan, I think is pretty unique in an ASC.

So, you’ve got a fire drill, and you’ve got a fire exit drill. And so, when we talk about a fire response plan for an ASC, the responses are going to be different for those two types of fires. If you’ve got a fire in your waiting room, that RACE acronym I talked about is the perfect application for how you respond to that.

But RACE doesn’t make as much sense in the or, so look up the, another good resource for this is with AORN. They talk a lot about fires and operating rooms, and that triangle of you’ve got the source of ignition, the oxygen and the fuel, and how each person in that environment controls their part of it.

So, make sure that your fire response plan really addresses both instead of just an all-encompassing plan.

[00:13:19] Grant Duncan: What is one thing our listeners can do this week to improve their surgery centers?

[00:13:25] Katie Sypher: Okay, well, I will go first. I actually was at book club last night and I asked the girls in my book club, I said, okay, who’s had surgery?

Who’s had day surgery? And I brought up an idea of something that anybody could do this week is go in the waiting room. Talk to the caregiver. Talk to five caregivers that are waiting for their loved one to come out of surgery and ask them two specific questions. What went well from a communication standpoint?

What did you feel went really well and what were the most frustrating things? You can talk to five people, and you could clearly quickly identify, there may be some opportunities to make some really quick changes that could aid in doing what you’re doing. So, celebrate those wins and then change the communication, how it’s communicated or what’s communicated to really improve that experience for them.

[00:14:15] Michael McClain: I’m going to go the other way. I’m going to go very anti-technology here today. Usually, I talk about patient communication and patient satisfaction, but you know, survey season is upon us. It seems like lots of places are getting surveyed through the summer and fall. Go in your ASC grab your camera and a clipboard.

Go look at every single certificate you have on every single wall. Make sure they all are current. You would be surprised how many boiler certificates. Triple AAA HC or quad ASF or Medicare license is not up to date. You have the right one probably sitting in your desk on a file. It’s scanned. It’s in your EHR.

It’s in your quality software, but it’s not on the wall. Just take the time, check everyone, take pictures of the ones that are and replace them. It just saves you a little bit of headache with the next survey. We’re the patient that’s bored and walking around, or the caregiver that notices twice is not licensed it, it’s worth the five, 10 minutes to do the walk around.

[00:15:26] Vanessa Sindell: You know, if you have the capability, print out or export that item, master and clean it. You know, that can definitely be done this week. I think just taking the time to focus on that and, you know, maybe you can’t get through every item in one fell swoop, but working through it, you know, updating the names, looking at the unit of measures, looking at how they’re categorized and looking at the prices, I think will go a mile to just, you know, improve what you have as a foundation.

[00:15:58] Nancy Stephens: I would say, um, collaborate and benchmark. You know, if you go in for the, the best-case scenario, set a goal for you to be able to show your docs, their case thrusting against each other, and then really important to measure yourself against the industry. What else is going on in the industry for your cost per case data and then also compared to revenue.

So that’s really the biggest thing, is what does that supply ratio look like for you, your EFC, compared to other ASCs in the same space. You know, we published for a long-time benchmarking data on cost supply, cost supply ratios. You really have to figure out where your facility is compared to your peers, right?

So having that bench working data is just so important. And that’s the first thing the docs are going to ask. You know, so this is where we are, where are we compared to others? And if you don’t understand where you are, what’s acceptable for a cost per piece in the industry may not work for you because of your peer contracts.

You could be upside down when someone else is getting three times the rate. So, you need to understand where you need to like cut costs and really. Spend that time and energy into getting that great contract, looking at your GPOs and making sure you’re not overpay.

[00:17:19] Erica Palmer: What is one thing our listeners can do this week to improve their surgery centers?

[00:17:24] Josh Rudd: So, I think probably the one thing that I would. That keeps our surgery center and continues to be as successful starting as it has been, was the complete buy-in from the physicians. So, all of the physicians have ownership in the surgery center. So, they’re all a hook for the money, and so that makes them all very adept at trying to make it work, even if they’re not happy with the software or instrument or whatnot.

Everybody’s in the same boat on trying to make it profitable and start. Getting back to even. And so, it’s got everybody focused on one mission and so that, that has been one of the biggest advantages I think our practice, our surgery center has over most is just the complete buy-in from all of the physicians because they’re all investors.

[00:18:19] Nyleen Flores: Love your nurses that take care of you. Bring in something to your surgery center after you had surgery and you don’t remember what happened. Just know that they took really good care of you. So go say thank you to the nurses and the teams that took care of you.

[00:18:37] Shannen Reyes: And I would say you, y’all ain’t going to like my answer. I would say to do a random audit on your credentialing file.

[00:18:46] Nyleen Flores: Amen, sister. Okay, I’ll double that one.

[00:18:49] Shannen Reyes: And do a random audit on your monitoring program. And I know that seems crazy and I know it’s like what? Who wants to do extra work? But when you’re really looking at it from an auditor perspective and from wanting to ensure that your compliance is up to date and that you’re on point, that is the best thing that you could do for your surgery center is to ensure that there are no credentialing issues and that if anybody comes in there to look over your items, that they see that you take care of this department as well as you’re taking care of the surgery and the, all the things that are done in the OR.

[00:19:20] Kevin Turner: So, I would recommend, and I know this is a pain in the butt, but make sure you’ve updated your IT policies and procedures. It’s one of those things that’s pretty, pretty much on the back burner of everyone’s list, and I know a lot of times the administrators just cruise through them once a year to make sure, hey, I’ve touched my policies, but this year is.

OCR and CMS are updating HIPAA high tech, and there’s going to be a whole new set of things that are going to be required. Now, technically speaking, they’re already in the law, but because of the way it was written and the way the final rule was produced in 2018, there’s been a lot of failures and from an audit perspective, from OCR viewpoint.

So, they’re going back to circle back around the. Changes were introduced. They were put out for request for comments. That process, I think, ended March 7th, March 17th, sometime in March. And they’re reviewing all of the comments now. So, we expect sometime before the end of the year that they’re going to make all of the changes.

Official, you can go out to the CMS OCRR website, and it will actually list them. It’s pretty legal ease, a lot of text, but your policies and procedures are going to have to be updated. I would say wait till those come out and make sure that you get them done in a timely fashion. But one of the requirements that we know is going to make it is they’re going to absolutely require you to have your data documented in a basically a Visio chart.

So where does your data reside? Everywhere in your environment, you know, spec the patient data, essentially. So, your policies and procedures, those documents, diagrams, make sure those are completed. You’ll have 180 days once the rule goes final, but I would say don’t wait. I would say as soon as the rule’s final, get working on that because you don’t want to get caught at the end of that time period.

[00:21:25] Carol Hiatt: Start measuring where you are against where you should be. Learn what your numbers are and learn where you need to go. Because if you don’t have a goal and you don’t know where you are, then it’s going to be a frustrating thing. That’s the most important thing I believe that our listeners can do. Start measuring where you are, comparing to where you want to go, and start taking incremental steps.

[00:21:49] Alex Taira: I may have said this in a previous appearance, but I think get involved in local advocacy I ask is really nationally focused. I think we’ve seen a big increase in stuff happening at the state level, at the local level that affects ASCs. You know, that’s reimbursement issues, prior authorization, EHRs, you name it.

We’re seeing a lot more issues prop up at the state level. I think one of the best things you can do to make sure that these things aren’t burdensome, that your state governments are understanding about your place and their healthcare delivery system is to, uh, get involved. Whether that’s your state association, maybe hosting a facility tour from one of your state, your local officials coming to the fly in.

These things really make a big difference. And I think we’re trying to keep track of the federal stuff, but a lot of the times we need help from the grassroots level to combat some of these issues that are happening at the state level. So, it really can’t be overstated. If you have a state association, you have a local organization, please get involved because these things make a huge difference.

[00:22:49] Michael Bernard: I would say pull out your boarding criteria. That’s a quick thing. Just look at it and say, are you outdated? Are there things, there’s reasons that you can maybe say, instead of not bringing this case, find a reason why to bring a case. You know, if your BMI cutoff is artificially low.

And can you provide the support to allow cases that are, you know, heavier patients if you’re doing total joints. Morbidly obese patients tend to be the ones that are young and well insured. So to, to kick those cases out of your center, just purely on that criteria, you’re really losing a lot. For the center.

[00:23:24] Colleen Ramirez: My answer is to grab some baked goods and visit every single physician office that provides cases to your center and sit down with their schedulers even for 15 or 20 minutes, bring them some swag, whatever you have to do. But definitely they are the ones that’s a ticket to bring in cases to your center. So, I highly advise that you sit down periodically with them but and ensure that they want to bring cases and they understand which ones could come.

[00:23:54] Jeffrey Flynn: I will tell you, go through your own center as a patient, and if you do it, and maybe just doing it virtually, but go through, look at the whole chair in your center itself, and if you can walk out of there saying, I’m really proud of what I just saw, and you’re doing a great job. But more importantly, if you find a lapse in it, don’t get angry at that lapse.

It’s a point of education. It’s a chance for learning. It’s something that we haven’t encouraged a particular person to know that. That would be the one thing I would tell you to do in that situation to improve your center. But the other aspect is because we are a big community, join your state associations because the networking, and it’s not just the officers, it’s the networking of the people you meet at these different conferences. You want to be able to call somebody who lives your life and get advice from that person, get a different perspective. And I’ve been so fortunate to have that opportunity because of the state association, it’s often, I have conversations with people, and it was like, I never thought of it that way. I remember sitting down with a board member. The board member said to me, we’re not the charm job we once were, we’re doing higher acuity procedures. This isn’t that. We’re just doing a simple seven to three. We walk out the door, don’t think of it till the next day.

Those are the surgery centers of the nineties. So, in understanding that your nurses, your nursing directors and stuff have to go through much more, the job’s more stressful than it was 25 years ago. And it’s important that we, as the operators of surgery centers understand that and really understand what your staff facing, but more importantly, what is your patient facing.

I remember when that person said that to me. I was just so stunned. It’s not the easy job that it once was. You’re doing joint replacements, we’re doing laparoscopic sleeves, laparoscopic. General surgeries. We need to recognize that. And that was really eye-opening when that person said that to me. She was absolutely right.

[00:25:43] Benita Tapia: I think this is easy for me. It’s a team effort. It’s not just me. It’s not just Conor the vendor. He becomes part of our team too, and the thing is that you have to listen to your team and if there’s an issue or a problem, we can work it out as a team. I am not an administrator that’s ever punitive. If you have a problem or you’ve made a mistake, come tell me.

We’ll fix it together. We’ll figure out a way for it not to happen again. I love that. And what about you, Connor?

[00:26:20] Conor McGinn: I think kind of two general kind of points. One would be to like incentivize people on the ground to engage in technology adoption. Because again, I think that there can be a challenge as an outsider or a vendor coming in because like if people are very busy and it’s like what they’re being.

Promoted and incentivized to do is the day to day. It can be kind of difficult. It takes a while to figure out how to make this work well for them, and as Bonita says, like our job is, is to make life easier. But if there’s people that are not incentivized to engage with us, then it’s really hard to get to a position of doing that and understanding that there is a little bit of upfront you support needed in the early days to just get us a point where it adds value in the medium to long term.

I think going beyond that, we’re extending that is that viewing vendors less as a kind of transactional thing. And I think this is a really nice thing within the ASC business. It seems like it’s much more collegial than some other places we’ve experienced where you’re kind of working together towards a shared objective and a shared goal.

It’s not just a case of like, you know, you do this and we’ll do this and it stays that way. We’ve benefited, I think, mutually by being able to, you know, learn what the actual pain points are and similarly get the opportunity to work closer with them to customize and build bespoke systems. And that’s a mindset.

If you expect us to work out of the box immediately, that’s a much harder expectation to live up to.

[00:27:31] Melissa Rice: Being a part of an association, being able to go to Becker’s and ASCA and OR Manager and you know, the AAA stuff and Joint Commission, network. Don’t stop.

Network. The more you reach out to your colleagues, the more you’re not going to feel like you’re on an island by yourself. because some of us do. It is a very, uh, specialized role that we take on. But I would say network, whether it is to subscribe to podcasts, because they’re all amazing, including this one.

Or be able to go to the conferences or be a part of state leaderships or be part of the ASCA stuff. Networking is key. It’s really going to open your doors to being able to have these really great conversations that we’re having together. You know, the way I do things might do an aha moment to someone or me listening to one of your other product answers.

I’d be like, oh, maybe I could take that perspective as well and it might help me out. I just feel like networking is key right now in our space, particularly for ASCs, but just healthcare in general. So that would be my one thing. I’d say do.

[00:28:28] Gavin Fabian: Oh, check the quality of your cost data and where there are gaps or things that don’t look right, put in a plan to get good cost data hygiene because it’ll pay dividends all over the place. Whether it’s when you’re trying to negotiate better pricing, whether you’re trying to forecast your cases, what, whatever it may be, improving the quality of your cost data will just serve all sorts of purposes.

[00:28:52] Alex Larralde: if you could give people advice on one thing they can do this week to improve their surgery centers, what tip would you give everybody out there?

[00:29:01] Wes Battiste: One thing. On your busiest day this week, you’ve got, if your busy day is 20 cases, or your busy day is 50 cases, on your busiest day this week, go around, I call it pat and butts and kissing babies. Cheer cheerlead your folks. Tell them you recognize how hard they’re working, you value them and then buy lunch for your center. Your busiest day of the week. Just see how far it gets. Just see what it does for you. It’ll do wonders.